Occlusion of the vena cava in infants receiving central venous hyperalimentation.
During a five year period at UCLA Hospital, 118 Silastic, Broviac, central venous hyperalimentation catheters were inserted into 94 infants who were less than one year of age. The indications for total parenteral nutrition were malabsorption syndrome in 26, short bowel syndrome in 24, diarrhea in 15, nutritional support following operation in 11 and miscellaneous in 18. One hundren and two catheters were placed into the vena cava by way of the saphenous vein at the groin, and 16 were inserted through the external or internal jugular veins. The duration of catheter use varied from six to 925 days, a mean of 104 days. In six infants, obstruction of the vena cava developed, five in the inferior vena cava and one in the superior vena cava. Swelling of the extremity was minimal, and the thrombosis was insidious in each patient. None of the patients had pulmonary emboli. Although two of the six patients eventually died, in neither was thrombosis of the cava believed to be related. Thrombosis of the vena cava is a frequent sequela of long term central venous hyperalimentation in infants, but it is rarely fatal and produces remarkably few serious complications.
D002408:Catheters, Indwelling / Q000009:adverse effects*; D003968:Diarrhea, Infantile / Q000628:therapy; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008286:Malabsorption Syndromes / Q000628:therapy; D008297:Male; D010288:Parenteral Nutrition / Q000009:adverse effects*; D010289:Parenteral Nutrition, Total / Q000009:adverse effects*; D011183:Postoperative Complications / Q000628:therapy; D011859:Radiography; D012501:Saphenous Vein; D013927:Thrombosis / Q000209:etiology*; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging; D014683:Vena Cava, Superior / Q000000981:diagnostic imaging; D014684:Venae Cavae / Q000000981:diagnostic imaging